Nuclear pore protein POM121 regulates subcellular localization and transcriptional activity of PPARγ

Manipulation of the subcellular localization of transcription factors by preventing their shuttling via the nuclear pore complex (NPC) emerges as a novel therapeutic strategy against cancer. One transmembrane component of the NPC is POM121, encoded by a tandem gene locus POM121A/C on chromosome 7. Overexpression of POM121 is associated with metabolic diseases (e.g., diabetes) and unfavorable clinical outcome in patients with colorectal cancer (CRC). Peroxisome proliferator-activated receptor-gamma (PPARγ) is a transcription factor with anti-diabetic and anti-tumoral efficacy. It is inhibited by export from the nucleus to the cytosol via the RAS-RAF-MEK1/2-ERK1/2 signaling pathway, a major oncogenic driver of CRC. We therefore hypothesized that POM121 participates in the transport of PPARγ across the NPC to regulate its transcriptional activity on genes involved in metabolic and tumor control. We found that POM121A/C mRNA was enriched and POM121 protein co-expressed with PPARγ in tissues from CRC patients conferring poor prognosis. Its interactome was predicted to include proteins responsible for tumor metabolism and immunity, and in-silico modeling provided insights into potential 3D structures of POM121. A peptide region downstream of the nuclear localization sequence (NLS) of POM121 was identified as a cytoplasmic interactor of PPARγ. POM121 positivity correlated with the cytoplasmic localization of PPARγ in patients with KRAS mutant CRC. In contrast, POM121A/C silencing by CRISPR/Cas9 sgRNA or siRNA enforced nuclear accumulation of PPARγ and activated PPARγ target genes promoting lipid metabolism and cell cycle arrest resulting in reduced proliferation of human CRC cells. Our data suggest the POM121-PPARγ axis as a potential drugable target in CRC.

Horner syndrome-A rare complication after thyroidectomy for benign thyroid swelling

Horner syndrome occurring after thyroidectomy is a rare entity and most of the reported cases have happened after surgeries on malignant thyroid swellings. In the present report, we describe a 27-year-old female who developed ptosis, miosis, enophthalmos, and anhidrosis on the second post-operative day after thyroidectomy for benign goiter. Post-operative ultrasound, computed tomography of neck, nerve conduction study, and electromyography of brachial plexus were unremarkable. Patient was kept on conservative management. She was given short course of Prednisolone orally for 2 weeks and was discharged on 150 mcg thyroxine. She had significant improvement in ptosis, miosis, and enophthalmos after six months. Horner syndrome is a rare but an important complication after thyroidectomy which may lead to cosmetic disfigurement. Surgeons should be well aware of this possibility and its presentation for timely recognition and management postoperatively. Early intervention should be done for any reversible cause, i.e., hematoma and oral steroids should be initiated as early as possible.

NLRP3 signaling drives macrophage-induced adaptive immune suppression in pancreatic carcinoma

The tumor microenvironment (TME) in pancreatic ductal adenocarcinoma (PDA) is characterized by immune tolerance, which enables disease to progress unabated by adaptive immunity. However, the drivers of this tolerogenic program are incompletely defined. In this study, we found that NLRP3 promotes expansion of immune-suppressive macrophages in PDA. NLRP3 signaling in macrophages drives the differentiation of CD4+ T cells into tumor-promoting T helper type 2 cell (Th2 cell), Th17 cell, and regulatory T cell populations while suppressing Th1 cell polarization and cytotoxic CD8+ T cell activation. The suppressive effects of NLRP3 signaling were IL-10 dependent. Pharmacological inhibition or deletion of NLRP3, ASC (apoptosis-associated speck-like protein containing a CARD complex), or caspase-1 protected against PDA and was associated with immunogenic reprogramming of innate and adaptive immunity within the TME. Similarly, transfer of PDA-entrained macrophages or T cells from NLRP3-/- hosts was protective. These data suggest that targeting NLRP3 holds the promise for the immunotherapy of PDA.

Assessing Attitudes and Perceptions of Obstructive Pulmonary Disease Patients towards Inhaler Therapy in a Low Income Country: A Cross Sectional Study

Chronic respiratory diseases (CRD) like asthma and chronic obstructive pulmonary disease (COPD) are one of the leading causes of morbidity and mortality worldwide. A patient's perception, about his or her medicine, may have an impact on adherence to medications. The purpose was to assess the attitudes and perceptions, regarding inhaler therapy use, among patients with obstructive pulmonary disease in Pakistan, a developing country. With a questionnaire developing this cross-sectional study was conducted at the Department of Medicine's outpatient clinic at Civil Hospital, Karachi from October 2013 to January 2014. We used SPSS version 19 for data entry. The number of patients included in the study was 202. Fifty eight percent (58%) of the patients concurred that they were not compliant with the usage of inhalers and frequently missed their doses. Thirty three percent (33%) patients had the misconception that inhalers are prescribed for severe diseases only. Almost forty percent (40%) patients said that they would prefer oral medicines over inhalers for the management of their lung diseases. Sixteen percent (16%) of the patients had problems using their inhalers. Twenty six percent (26%) of the patients believed that inhalers have side effects. Thirty eight percent (38%) of the patients believed inhalers are addictive. Misconceptions regarding inhalers and its usage in asthma and COPD patients are common in Pakistan. These misconceptions not only lead to poor compliance with medications prescribed but also to frequent visits to hospitals. There is a need to educate patients in the country regarding inhalers in order to improve not only their symptoms, but also to improve their quality of life.

Patterns, timing and consequences of post-thyroidectomy haemorrhage

INTRODUCTION Post-thyroidectomy bleeding is a low frequency but potentially life threatening event that is very difficult to predict. Given the increasing drive towards thyroidectomy with same day discharge, this study was conducted with the aim of identifying patterns, timing and consequences of post-thyroidectomy bleeding to assess the feasibility of day-case thyroidectomy. METHODS All patients who underwent a thyroidectomy between 2008 and 2015 at our institution were identified. Patterns, timing and consequences in all those who developed post-thyroidectomy bleeding were studied. RESULTS Of the 805 patients included in the study, 14 required re-exploration for bleeding; 7 (50%) of these within 8 hours of surgery, 6 (43%) between 18 and 30 hours, and 1 (7%) at 49 hours. Just under half (43%) of those with post-thyroidectomy bleeding had thyrotoxicosis. CONCLUSIONS A significant number of postoperative haemorrhages occurred beyond the immediate postoperative period. Same day discharge after thyroidectomy cannot therefore be recommended as a routine practice.

Sero-epidemiology of peste des petits ruminants (PPR) in Pakistan

A sero survey was conducted during 2005-2006 to estimate the sero prevalence of PPR in the small ruminant population of Pakistan. A total of 2798 samples were collected including goats (1979) and sheep (819) from villages in 27 randomly selected districts. These were tested by cELISA for PPRV and true prevalence estimates were calculated by Rogan and Gladen estimator. Overall, 1273 (45.5%) were found positive; 980 (49.5%) of 1979 samples from goats and 293 (35.8%) of 819 serum samples from sheep were positive. The true sero-prevalence of PPR was estimated to be 48.5% (95% CI, 46.6-50.3), and 52.9% (95% CI, 50.7-55.1) and 37.7 (95% CI, 34.4-41.0) for goats and sheep, respectively. PPR virus is widely distributed all across Pakistan and has become an endemic infection of small ruminants. Since it is one of the leading causes of morbidity and mortality in small ruminants, it poses a serious threat to food security and the rural economy in Pakistan.